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Hussain H, Elumalai N, Sampath N, Shamaladevi N, Hajjar R, Druyan BZ, Rashed AB, Ramamoorthy R, Kenyon NS, Jayakumar AR, Paidas MJ. Acute and Long COVID Intestinal Changes in an Experimental Model of Coronavirus in Mice. Viruses 2024; 16:832. [PMID: 38932125 PMCID: PMC11209276 DOI: 10.3390/v16060832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/22/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
The COVID-19 pandemic, which emerged in early 2020, has had a profound and lasting impact on global health, resulting in over 7.0 million deaths and persistent challenges. In addition to acute concerns, there is growing attention being given to the long COVID health consequences for survivors of COVID-19 with documented cases of cardiovascular abnormalities, liver disturbances, lung complications, kidney issues, and noticeable cognitive deficits. Recent studies have investigated the physiological changes in various organs following prolonged exposure to murine hepatitis virus-1 (MHV-1), a coronavirus, in mouse models. One significant finding relates to the effects on the gastrointestinal tract, an area previously understudied regarding the long-lasting effects of COVID-19. This research sheds light on important observations in the intestines during both the acute and the prolonged phases following MHV-1 infection, which parallel specific changes seen in humans after exposure to SARS-CoV-2. Our study investigates the histopathological alterations in the small intestine following MHV-1 infection in murine models, revealing significant changes reminiscent of inflammatory bowel disease (IBD), celiac disease. Notable findings include mucosal inflammation, lymphoid hyperplasia, goblet cell hyperplasia, and immune cell infiltration, mirroring pathological features observed in IBD. Additionally, MHV-1 infection induces villous atrophy, altered epithelial integrity, and inflammatory responses akin to celiac disease and IBD. SPIKENET (SPK) treatment effectively mitigates intestinal damage caused by MHV-1 infection, restoring tissue architecture and ameliorating inflammatory responses. Furthermore, investigation into long COVID reveals intricate inflammatory profiles, highlighting the potential of SPK to modulate intestinal responses and restore tissue homeostasis. Understanding these histopathological alterations provides valuable insights into the pathogenesis of COVID-induced gastrointestinal complications and informs the development of targeted therapeutic strategies.
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Affiliation(s)
- Hussain Hussain
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.H.); (N.E.); (R.H.); (B.Z.D.); (A.B.R.); (R.R.)
- Department of Internal Medicine, HCA Florida Kendall Hospital, Miami, FL 33175, USA
| | - Nila Elumalai
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.H.); (N.E.); (R.H.); (B.Z.D.); (A.B.R.); (R.R.)
| | - Natarajan Sampath
- School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur 613401, India;
| | | | - Rima Hajjar
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.H.); (N.E.); (R.H.); (B.Z.D.); (A.B.R.); (R.R.)
| | - Brian Zachary Druyan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.H.); (N.E.); (R.H.); (B.Z.D.); (A.B.R.); (R.R.)
| | - Amirah B. Rashed
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.H.); (N.E.); (R.H.); (B.Z.D.); (A.B.R.); (R.R.)
| | - Rajalakshmi Ramamoorthy
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.H.); (N.E.); (R.H.); (B.Z.D.); (A.B.R.); (R.R.)
| | - Norma S. Kenyon
- Microbiology & Immunology and Biomedical Engineering, Diabetes Research Institute, University of Miami, Miami, FL 33136, USA;
| | - Arumugam R. Jayakumar
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.H.); (N.E.); (R.H.); (B.Z.D.); (A.B.R.); (R.R.)
| | - Michael J. Paidas
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (H.H.); (N.E.); (R.H.); (B.Z.D.); (A.B.R.); (R.R.)
- Department of Biochemistry and Molecular Biology, The University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Mattioli LB, Frosini M, Corazza I, Fiorino S, Zippi M, Micucci M, Budriesi R. Long COVID-19 gastrointestinal related disorders and traditional Chinese medicine: A network target-based approach. Phytother Res 2024; 38:2323-2346. [PMID: 38421118 DOI: 10.1002/ptr.8163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 03/02/2024]
Abstract
The significant number of individuals impacted by the pandemic makes prolonged symptoms after COVID-19 a matter of considerable concern. These are numerous and affect multiple organ systems. According to the World Health Organization (WHO), prolonged gastrointestinal issues are a crucial part of post-COVID-19 syndrome. The resulting disruption of homeostasis underscores the need for a therapeutic approach based on compounds that can simultaneously affect more than one target/node. The present review aimed to check for nutraceuticals possessing multiple molecular mechanisms helpful in relieving Long COVID-19-specific gastrointestinal symptoms. Specific plants used in Keywords Chinese Medicine (TCM) expected to be included in the WHO Global Medical Compendium were selected based on the following criteria: (1) they are widely used in the Western world as natural remedies and complementary medicine adjuvants; (2) their import and trade are regulated by specific laws that ensure quality and safety (3) have the potential to be beneficial in alleviating intestinal issues associated with Long COVID-19. Searches were performed in PubMed, Elsevier, Google Scholar, Scopus, Science Direct, and ResearchGate up to 2023. Cinnamomum cassia, Glycyrrhiza uralensis, Magnolia officinalis, Poria cocos, Salvia miltiorrhiza, Scutellaria baicalensis, and Zingiber officinalis were identified as the most promising for their potential impact on inflammation and oxidative stress. Based on the molecular mechanisms of the phytocomplexes and isolated compounds of the considered plants, their clinical use may lead to benefits in gastrointestinal diseases associated with Long COVID-19, thanks to a multiorgan and multitarget approach.
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Affiliation(s)
- Laura Beatrice Mattioli
- Department of Pharmacy and Biotechnology, Food Chemistry and Nutraceutical Lab, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Maria Frosini
- Department of Life Sciences, University of Siena, Siena, Italy
| | - Ivan Corazza
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Sirio Fiorino
- Internal Medicine Unit, Azienda USL, Budrio Hospital, Bologna, Italy
| | - Maddalena Zippi
- Unit of Gastroenterology & Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy
| | - Matteo Micucci
- Department of Biomolecular Sciences, Università degli Studi di Urbino "Carlo Bo", Urbino, Italy
| | - Roberta Budriesi
- Department of Pharmacy and Biotechnology, Food Chemistry and Nutraceutical Lab, Alma Mater Studiorum-University of Bologna, Bologna, Italy
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3
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Silva BR, Monteiro FR, Cezário K, do Amaral JB, Paixão V, Almeida EB, dos Santos CAF, Amirato GR, Oliveira DBL, Durigon EL, Aguiar AS, Vieira RP, dos Santos JDMB, Furtado GE, França CN, Shio MT, Bachi ALL. Older Adults Who Maintained a Regular Physical Exercise Routine before the Pandemic Show Better Immune Response to Vaccination for COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1939. [PMID: 36767315 PMCID: PMC9915291 DOI: 10.3390/ijerph20031939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/23/2022] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In this study, we aimed to investigate the specific-antibody response to the COVID-19 vaccination and the immunophenotyping of T cells in older adults who were engaged or not in an exercise training program before the pandemic. METHODS Ninety-three aged individuals (aged between 60 and 85 years) were separated into 3 groups: practitioners of physical exercise vaccinated with CoronaVac (PE-Co, n = 46), or vaccinated with ChadOx-1 (PE-Ch, n = 23), and non-practitioners vaccinated with ChadOx-1 (NPE-Ch, n = 24). Blood samples were collected before (pre) and 30 days after vaccination with the second vaccine dose. RESULTS Higher IgG levels and immunogenicity were found in the PE-Ch and NPE-Ch groups, whereas increased IgA levels were found only in the PE-Ch group post-vaccination. The PE-Co group showed a positive correlation between the IgA and IgG values, and lower IgG levels post-vaccination were associated with age. Significant alterations in the percentage of naive (CD28+CD57-), double-positive (CD28+CD57+), and senescent (CD28-CD57+) CD4+ T and CD8+ T cells were found post-vaccination, particularly in the PE-Ch group. CONCLUSIONS The volunteers vaccinated with the ChadOx-1 presented not only a better antibody response but also a significant modulation in the percentage of T cell profiles, mainly in the previously exercised group.
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Affiliation(s)
- Brenda Rodrigues Silva
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | | | - Kizzy Cezário
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | - Jônatas Bussador do Amaral
- ENT Research Lab., Department of Otorhinolaryngology—Head and Neck Surgery, Federal University of Sao Paulo (UNIFESP), São Paulo 04021-001, Brazil
| | - Vitória Paixão
- ENT Research Lab., Department of Otorhinolaryngology—Head and Neck Surgery, Federal University of Sao Paulo (UNIFESP), São Paulo 04021-001, Brazil
| | - Ewin Barbosa Almeida
- ENT Research Lab., Department of Otorhinolaryngology—Head and Neck Surgery, Federal University of Sao Paulo (UNIFESP), São Paulo 04021-001, Brazil
| | - Carlos André Freitas dos Santos
- Discipline of Geriatrics and Gerontology, Department of Medicine, Paulista School of Medicine, Federal University of Sao Paulo (UNIFESP), São Paulo 04020-050, Brazil
- Postgraduate Program in Translational Medicine, Department of Medicine, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo 04023-062, Brazil
| | - Gislene Rocha Amirato
- Mane Garrincha Sports Education Center, Sports Department of the Municipality of Sao Paulo (SEME), São Paulo 04039-034, Brazil
| | - Danielle Bruna Leal Oliveira
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
- Laboratory of Clinical and Molecular Virology, Department of Microbiology, Institute of Biomedical Science, University of São Paulo, São Paulo 05508-060, Brazil
| | - Edison Luiz Durigon
- Laboratory of Clinical and Molecular Virology, Department of Microbiology, Institute of Biomedical Science, University of São Paulo, São Paulo 05508-060, Brazil
- Scientific Platform Pasteur, University of São Paulo, São Paulo 05508-060, Brazil
| | - Andressa Simões Aguiar
- Scientific Platform Pasteur, University of São Paulo, São Paulo 05508-060, Brazil
- Infection Control Service, São Luiz Gonzaga Hospital of Santa Casa de Misericordia of São Paulo, São Paulo 02276-140, Brazil
| | - Rodolfo P. Vieira
- Post-graduate Program in Human Movement and Rehabilitation and in Pharmaceutical Sciences, Universidade Evangélica de Goiás (Unievangelica), Av Universitária km 3,5, Anápolis-Go 75083-515, Brazil
| | | | - Guilherme Eustáquio Furtado
- Polytechnic Institute of Coimbra, Applied Research Institute, Rua da Misericórdia, Lagar dos Cortiços—S. Martinho do Bispo, 3045-093 Coimbra, Portugal
| | - Carolina Nunes França
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | - Marina Tiemi Shio
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
| | - André Luis Lacerda Bachi
- Post-Graduation Program in Health Sciences, Santo Amaro University (UNISA), São Paulo 04829-300, Brazil
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Bustamante S, Yau Y, Boys V, Chang J, Paramsothy S, Pudipeddi A, Leong RW, Wasinger VC. Tryptophan Metabolism 'Hub' Gene Expression Associates with Increased Inflammation and Severe Disease Outcomes in COVID-19 Infection and Inflammatory Bowel Disease. Int J Mol Sci 2022; 23:14776. [PMID: 36499104 PMCID: PMC9737535 DOI: 10.3390/ijms232314776] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
The epithelial barrier's primary role is to protect against entry of foreign and pathogenic elements. Both COVID-19 and Inflammatory Bowel Disease (IBD) show commonalities in symptoms and treatment with sensitization of the epithelial barrier inviting an immune response. In this study we use a multi-omics strategy to identify a common signature of immune disease that may be able to predict for more severe patient outcomes. Global proteomic approaches were applied to transcriptome and proteome. Further semi- and relative- quantitative targeted mass spectrometry methods were developed to substantiate the proteomic and metabolomics changes in nasal swabs from healthy, COVID-19 (24 h and 3 weeks post infection); serums from Crohn's disease patients (scored for epithelial leak), terminal ileum tissue biopsies (patient matched inflamed and non-inflamed regions, and controls). We found that the tryptophan/kynurenine metabolism pathway is a 'hub' regulator of canonical and non-canonical transcription, macrophage release of cytokines and significant changes in the immune and metabolic status with increasing severity and disease course. Significantly modified pathways include stress response regulator EIF2 signaling (p = 1 × 10-3); energy metabolism, KYNU (p = 4 × 10-4), WARS (p = 1 × 10-7); inflammation, and IDO activity (p = 1 × 10-6). Heightened levels of PARP1, WARS and KYNU are predictive at the acute stage of infection for resilience, while in contrast, levels remained high and are predictive of persistent and more severe outcomes in COVID disease. Generation of a targeted marker profile showed these changes in immune disease underlay resolution of epithelial barrier function and have the potential to define disease trajectory and more severe patient outcomes.
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Affiliation(s)
- Sonia Bustamante
- Bioanalytical Mass Spectrometry Facility, Mark Wainwright Analytical Centre, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Yunki Yau
- Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, NSW 2139, Australia
| | - Victoria Boys
- School of Medical Sciences, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Jeff Chang
- Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, NSW 2139, Australia
| | - Sudarshan Paramsothy
- Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, NSW 2139, Australia
| | - Aviv Pudipeddi
- Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, NSW 2139, Australia
| | - Rupert W. Leong
- Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, NSW 2139, Australia
| | - Valerie C. Wasinger
- Bioanalytical Mass Spectrometry Facility, Mark Wainwright Analytical Centre, The University of New South Wales, Sydney, NSW 2052, Australia
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5
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Lashgari NA, Momeni Roudsari N, Momtaz S, Abdolghaffari AH. Transmembrane serine protease 2 and angiotensin-converting enzyme 2 anti-inflammatory receptors for COVID-19/inflammatory bowel diseases treatment. World J Gastroenterol 2021; 27:7943-7955. [PMID: 35046622 PMCID: PMC8678820 DOI: 10.3748/wjg.v27.i46.7943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/12/2021] [Accepted: 11/28/2021] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel diseases (IBD) refer to a subgroup of chronic, progressive, long-term, and relapsing inflammatory disorders. IBD may spontaneously grow in the colon, and in severe cases may result in tumor lesions such as invasive carcinoma in inflamed regions of the intestine. Recent epidemiological reports indicate that old age and underlying diseases such as IBD contribute to severity and mortality in patients with coronavirus disease 2019 (COVID-19). Currently, the ongoing COVID-19 pandemic caused serious morbidity and mortality worldwide. It has also been shown that the transmembrane serine protease 2 is an essential factor for viral activation and viral engulfment. Generally, viral entry causes a 'cytokine storm' that induces excessive generation of proinflammatory cytokines/chemokines including interleukin (IL)-6, IL-2, IL-7, tumor necrosis factor-α, and interferon-γ. Future research could concentrate on developing inflammatory immunological responses that are efficient to encounter COVID-19. Current analysis elucidates the role of inflammation and immune responses during IBD infection with COVID-19 and provides a list of possible targets for IBD-regulated therapies in particular. Data from clinical, in vitro, and in vivo studies were collected in English from PubMed, Google Scholar, Scopus, and the Cochrane library until May 2021.
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Affiliation(s)
- Naser-Aldin Lashgari
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran 1941933111, Iran
| | - Nazanin Momeni Roudsari
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran 1941933111, Iran
| | - Saeideh Momtaz
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj 141554364, Iran
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran 1941933111, Iran
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1941933111, Iran
- Gastrointestinal Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran 1941933111, Iran
| | - Amir Hossein Abdolghaffari
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran 1941933111, Iran
- Medicinal Plants Research Center, Institute of Medicinal Plants, ACECR, Karaj 141554364, Iran
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran 1941933111, Iran
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1941933111, Iran
- Gastrointestinal Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran 1941933111, Iran
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Mohammadi G, Sotoudehnia Koranni Z, Jebali A. The oral vaccine based on self-replicating RNA lipid nanoparticles can simultaneously neutralize both SARS-CoV-2 variants alpha and delta. Int Immunopharmacol 2021; 101:108231. [PMID: 34655852 PMCID: PMC8495003 DOI: 10.1016/j.intimp.2021.108231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/22/2021] [Accepted: 10/04/2021] [Indexed: 12/26/2022]
Abstract
The aim of this study was to evaluate self-replicating RNA lipid nanoparticles (saRNA LNPs) to neutralize SARS-CoV-2 variants delta (B.1.617 lineage) and alpha (B.1.1.7 lineage). Before immunization of mice with saRNA LNPs, we saw high expression of S-protein at both mRNA and protein levels after transfection of HEK293T/17 cells with saRNA LNPs. After oral immunization of BALB/c mice with 0.1 - 10 µg saRNA LNPs , a high quantity of SARS-CoV-2 specific IgG and IgA antibodies were seen with a dose-dependent pattern. Importantly, the ratio of IgG2a/IgG1 in serum of vaccinated mice showed Th1/Th2 skewing response. We also found that the secreted antibodies could neutralize SARS-CoV-2 variants delta (B.1.617 lineage) and alpha (B.1.1.7 lineage). Re-stimulated splenocytes of vaccinated mice showed high secretion of IFN-γ, IL-6, and TNF- α . The authors think that although the preclinical study confirmed the efficacy of saRNA LNPs against SARS-CoV-2, the actual efficacy and safety of the oral vaccine must be evaluated in clinical trials.
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Affiliation(s)
| | | | - Ali Jebali
- Department of Medical Nanotechnology, Faculty of Advanced Sciences and Technology, Tehran Medical Science, Islamic Azad University, Tehran, Iran.
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Mansouri P, Chalangari R, Martits‐Chalangari K, Mozafari N. Stevens-Johnson Syndrome due to COVID-19 vaccination. Clin Case Rep 2021; 9:e05099. [PMID: 34815881 PMCID: PMC8593881 DOI: 10.1002/ccr3.5099] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 01/01/2023] Open
Abstract
As public COVID-19 vaccination programs are being implemented, it is possible that more rare and serious adverse effects such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) may occur.
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Affiliation(s)
- Parvin Mansouri
- Skin and Stem Cell Research CenterTehran University of Medical ScienceTehranIran
- Medical Laser Research CentersAcademic Center for Education, Culture and ResearchTehran University of Medical SciencesTehranIran
| | | | | | - Nikoo Mozafari
- Skin Research CenterShahid Beheshti University of Medical SciencesTehranIran
- Department of DermatologyLoghman Hakim HospitalShahid Beheshti University of Medical SciencesTehranIran
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8
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Neither inflammatory bowel disease nor immunosuppressants are associated with an increased risk of severe COVID-19: an observational Dutch cohort study. Clin Exp Med 2021; 22:465-476. [PMID: 34542781 PMCID: PMC8450711 DOI: 10.1007/s10238-021-00755-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/19/2021] [Indexed: 12/19/2022]
Abstract
Conflicting data about inflammatory bowel disease [IBD] and immunosuppressants are risk factors for severe COVID-19 confuse patients and healthcare providers. Clinical reports with longer follow-up are lacking. A retrospective search was performed for severe COVID-19 (hospital admission and/or mortality) one year after the SARS-CoV-2 outbreak in an IBD cohort from one of the most affected Dutch regions. Cohort characteristics were explored by value-based healthcare data, including immunotherapy. COVID-19 cases were detected by ICD-10 codes and further examined for IBD determinants (including medication) and COVID-19 characteristics (intensive care admission, respiratory support, treatment, mortality). The national mortality register was consulted, ensuring detection of patients that died without admission. Results were compared with regional and national general population registries. The IBD cohort consisted of 1453 patients (51% Crohn’s disease, 54% women, 39.9% using immunotherapy), including children. Biologics use increased during the study. Eight cases (0.55%) had severe COVID-19: seven were hospitalized (0.48%, 95% confidence interval [CI] 0.21–1.04), and two died (0.14%, CI 0.002–0.55). Six patients had comorbidity, one used immunotherapy, and four had no medication. Both deceased patients were older than 80 years, had severe comorbidity, but used no immunotherapy. Hospitalization occurred significantly more in the IBD cohort than regionally (0.18%, CI 0.17–0.19, p = 0.015), but not significantly more than nationally (0.28%, CI 0.279–0.284). Mortality was equal in IBD patients, regionally (0.11%, CI 0.10–0.12) and nationally (0.13%, CI 0.125–0.128). Neither IBD nor immunosuppressants are associated with increased risks of severe COVID-19 in an observational study with one-year follow-up.
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9
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Chen F, Dai Z, Huang C, Chen H, Wang X, Li X. Gastrointestinal Disease and COVID-19: A Review of Current Evidence. Dig Dis 2021; 40:506-514. [PMID: 34510032 PMCID: PMC8678221 DOI: 10.1159/000519412] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/30/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented and catastrophic impact on humanity and continues to progress. In addition to typical respiratory symptoms such as fever, cough, and dyspnea, a large percentage of COVID-19 patients experience gastrointestinal (GI) complaints, with the most common symptoms being diarrhea, nausea, vomiting, and abdominal discomfort. SUMMARY We comprehensively summarize the latest knowledge of the adverse effects of COVID-19 and therapeutic drugs on the GI system, as well as related disease pathogenesis, and then provide a discussion focusing on the management and vaccination of patients who have inflammatory bowel disease (IBD) and GI cancer. The virus can affect the digestive system via binding to ACE2 receptors and subsequent gut microbiome dysbiosis. Through a variety of molecular pathways and mechanisms, numerous drugs for the treatment of COVID-19 could interfere with GI function and lead to multiple clinical manifestations, which may further intensify the risk and severity of GI symptoms of COVID-19 infection, such as nausea, vomiting, gastroparesis, and gastric ulcers. KEY MESSAGES We should monitor GI manifestations closely while managing COVID-19 patients and take timely measures to reduce the incidence of SARS-CoV-2 infections in GI cancer patients. IBD patients should receive vaccination timely, but corticosteroid use should be minimized when they are vaccinated. Simultaneously, for persons with IBD who have known or suspected COVID-19, immunosuppressive agents, especially thiopurines, should be avoided/minimized if possible.
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Asadzadeh Aghdaei H, Jamshidi N, Chaleshi V, Jamshidi N, Sadeghi A, Norouzinia M, Zali MR. Virus in the pathogenesis of inflammatory bowel disease: role of Toll-like receptor 7/8/3. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2021; 14:295-303. [PMID: 34659656 PMCID: PMC8514217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/15/2021] [Indexed: 11/03/2022]
Abstract
The pathogenesis of inflammatory bowel disease (IBD) is influenced by immune system malfunction, particularly innate immune receptors such as toll-like receptors. Furthermore, it is critical to investigate the extremely close association between viruses and IBD incidence. Toll-like receptors (TLRs) 3, 5, and 7 are involved in antiviral immune responses. Finding a relationship between TLR-related virus and IBD is important not only for understanding the disease pathogenesis, but also for developing effective therapies. It has been shown that influenza is expressed more severely in patients with IBD who use immune system inhibitors, and the influenza vaccine is less effective in these patients. In dendritic cells, TLR7 and TLR8 regulate the production of interferons (IFNs) and inflammatory mediators. COVID-19 causes the production of IL-6, possibly due to the induction of TLR pathways. TLR activation by SARS-CoV-2 causes inflammation and IL-1 production, which induces the production of IL-6. Understanding TLR-associated viruses' molecular mechanisms can greatly help improve the quality of life of people with IBD. Therefore, the present study reviewed the role of TLR7, 8, and 3 in inflammatory bowel disease as well as their association with viral infections and evaluated different antagonists for the treatment of IBD.
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Affiliation(s)
- Hamid Asadzadeh Aghdaei
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negar Jamshidi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Chaleshi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Jamshidi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Sadeghi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Norouzinia
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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